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03i11/2013 21 33 tl319T P 002/002 <br /> I I <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, [VERETI', WA 98201 <br /> 4?.5-257-8810 - FAX 425-257-8857 —www.everettwa.o�g <br /> . � <br /> � /j Cc�eA' <br /> PROJECT AppkESS �`,�7 <br /> D�auo tit�c.�.i r��/ � �c��� 9tf'�� �-1'� Z�Z i <br /> Owner • MallAdtlross Gfy State2ip Phone <br /> TEna�t Mail Atltltess I <br /> ���Y Stale2lp �n� Phona <br /> ��l.11Ju�, .S'�f J'U Pa � l � I <br /> X 'S'�'1 fr'/Y �.�,2�/ .2s'� Z/(�i <br /> Eiedncal ContteMor Man Addrese CHy , Staterzi0 Phone <br /> F�t �-�4N.P1/��L/ � �Sn ''� <br /> Sta�e License Numbef ConUact Pflta of Work <br /> �.1�"G�l-L � ��-� <br /> Propocetl Usa or Buildmg Conlact Pe�Son (Plan Review) I <br /> Square Foolage(If rosidential new eonstruction,ramodel or addltion) <br /> Numbe�ol devices(If low��oltaga) <br /> Dascription of Work fo 8e Done: �. /! /" t,/�� �.Q('J�� �� <br /> FEE <br /> CITY OF EVERETT LOCAL SqLES TN(COp[IS 3105 � J' <br /> 1 hr,reby cerii/y fhat!hnve roatl and exnmined this application and knuw lhe Samo fo ba tni0 end � , <br /> correcG Ail provisions ollaws and or.linanees goveming thls.type olWork wiq bo complptad <br /> wha(he�Specified heroin.��not. Tho prantinq o(e pom7if does nof presuMo to gJvo aufhoRty to PERMiT'# <br /> violate or cancal the provlslons ofany othersteto orlocal faw mgulpfing cons�ruction or 7ho <br /> pedorq78nce ol constiuctioq. That l a�r1 authonzod by the awner o(this proporty fo podorm the � I � �,� — C�� <br /> work tor which epp!Ication is mado and!comply with tho Statq Contractors Law 18.27 RCW and <br /> 296.20D WAC. � <br /> ' / <br /> a ure peta <br /> . `-:�5 �i't'✓f] � ' <br />